In cellulitis, which antibiotic is an appropriate first-line option when MRSA risk is present?

In cellulitis, which antibiotic is an appropriate first-line option when MRSA risk is present?

• A. Cephalexin
• B. Clindamycin
• C. Amoxicillin
• D. Doxycycline

Answer: (B)

When MRSA risk is present in cellulitis, you want an antibiotic that covers MRSA as well as the usual streptococcal pathogens responsible for cellulitis. Clindamycin fits this need because it reliably targets both MRSA and beta-hemolytic streptococci and achieves good skin and soft tissue penetration, making it a solid first-line option in this scenario. Cephalexin and amoxicillin mainly cover streptococci and MSSA but not MRSA, so they’re less suitable when MRSA risk is a concern. Doxycycline does cover MRSA, but as a single-agent first-line option for cellulitis, clindamycin provides more robust and consistent coverage against the typical pathogens involved.

When MRSA risk is present in cellulitis, you want an antibiotic that covers MRSA as well as the usual streptococcal pathogens responsible for cellulitis. Clindamycin fits this need because it reliably targets both MRSA and beta-hemolytic streptococci and achieves good skin and soft tissue penetration, making it a solid first-line option in this scenario.

Cephalexin and amoxicillin mainly cover streptococci and MSSA but not MRSA, so they’re less suitable when MRSA risk is a concern. Doxycycline does cover MRSA, but as a single-agent first-line option for cellulitis, clindamycin provides more robust and consistent coverage against the typical pathogens involved.